Many health care businesses are recognizing the power of fitness and wellness services to expand revenues and market share from their circle of already-influenced patients. The single best way to improve a professional health care business is not to find more patients, but to leverage an existing circle of personal-influences from an already qualified prospect list — their patients. This is achievable by providing more preventative, healthy lifestyle solutions to people who already trust and value their health professional's advice. Unfortunately, most health care providers either have no time or are unfamiliar with the operational process to capitalize on this golden opportunity. This article is the first in a two-part series breaking down the essential resistance and cardiovascular (CV) equipment necessary to open and operate a health, fitness and wellness component in an established health care business while maximizing its execution for greatest market share and profits. The first part will outline what variables you need to consider when purchasing exercise equipment and a general formula for estimating expenses. The second part will describe how you can establish your Unique Selling Proposition (USP) and will focus primarily on a Member Intake Process (MIP) that systematically programs these tools and relative programs to close and up-sell prospects into health and wellness services, maximizing both revenue per member and revenue per square foot.

The Basics Obviously, function is vital during the selection process of the exercise equipment; however, it is not the only criteria in the evaluation process. To best maximize the purchase, look for equipment that can assist in separating your facility from the competition with more user-centered products. Factoring in that the majority of prospects in this type of setting will be first-time exercisers, the equipment should be designed to be distinctive and approachable so that prospects get excited and want to try out the equipment. While initial impressions are important to grab the prospects' attention and begin the inertia process of a healthy lifestyle, it is essential that the equipment is also designed to be intuitive while not intimidating or making any patient feel uncomfortable or stupid. Finally, the equipment should assist in inspiring and rewarding users so they are having fun and continue to use the equipment to achieve their desired results. While price is definitely a major decision factor in the purchasing process, buying cycles can alter how price is evaluated. The impact of buying cycles is magnified with resistance equipment. Unlike CV equipment, where technological changes and basic wear and tear may dramatically shorten the buying cycles to 12 to 36 months, resistance equipment lifespan averages anywhere between five to 10 years. Therefore, due to the long-term buying cycle with resistance equipment, any difference in price is insignificant compared to the others when weighed out over the duration of the buying cycle. The failure to factor in buying cycles and solely purchase on price usually results in buyers kicking themselves 12, 24 or 36 months down the road, wishing the resistance equipment could do more to positively impact the fitness business revenue triad (membership sales, membership retention and ancillary revenues) in relation to its return on investment (ROI). In addition to all of the accessory resistance equipment (physio-balls, wobble boards, dumbbells, medicine balls, tubing, etc.), you will need traditional selectorized machines with pin-adjustable weight stack equipment. Depending on available space and programming plans, forward-thinking facilities should look for machines that combine a pushing movement (chest, shoulder or tricep), a pulling movement (back and bicep) and a lower body and core stable selectorized resistance equipment with a multi-planar (e.g., functional trainer) machine. For the very small and limited capital start-ups, the addition of the multi-planar machine saves you money and space by eliminating the need for racks of heavier dumbbells and specialized flooring. This combination of total body movements allows for scientific periodization progression from basic strength to functional strength, which is best suited for this target audience.

What to Look for in CV Equipment Aside from the design platform described earlier to enhance the user experience, other specific points of interest for CV equipment include; warranty, tech support, mode and features. Unlike resistance equipment which is mostly metal, CV equipment is much like an appliance with an array of electronics. This makes a protective warranty vital to your facility's day-to-day operations. Unfortunately, most warranties are not created equal; thus, it is imperative to know the details. For instance, with treadmills, most warranties will cover the motor, but not the motor control board (MCB). Little details like this can make a difference in the price and lifespan of your equipment, so be sure to know what you are agreeing to with your sales representative. An ideal situation lies in a combination of a parts and labor warranty. If your facility is staffed with an on-site mechanic, then you will want to inquire about lessening the labor warranty in order to gain additional years with the parts warranty. Technical support is one of the biggest things to look for in CV equipment. If any eager salesperson tells you that their equipment will never break down, I highly recommend that you stay as far away as possible. With the type of use and abuse that most pieces of equipment take in high-use facilities, it is critical to know how you will be taken care of when any equipment does break down. Find out the response time for the manufacturers you are considering. Ask them who the nearest service providers are and how long they have been in business. Finally, ask for and check references of the tech support. When deciding on what types (mode) of CV equipment to purchase and their associated features, remember to always refer back to your target audience who will be utilizing the equipment everyday. For most facilities, the best recommendation for this setting is the basic three: treadmills, elliptical trainers and bikes.

CV Equipment: Bikes For the bikes category, you will need both an upright and recumbent bike, with a greater percentage of total bikes being recumbent, approximately two or three to one ratio. Users of the upright and recumbent bikes are different and should be viewed that way. Many recumbent bikes are built with your target audience in mind. These would include features such as a walk-thru design or swivel seat for easy access and mounting/ unmounting for limited mobility patients. This particular feature is a must for the older adults and hip replacement members. Other key "creature features" might include wrap-around seat adjustments for simple seat positional changes, an adjustable reading station that enables the user to move any reading material forward or back to best accommodate their vision and distract them from what may be an uncomfortable rehab assignment or arm rests to minimize tension in the shoulders while reading or watching TV. Remember this audience likes to disassociate themselves with exercise and will tend to exercise a little longer if they are comfortable on a product.

CV Equipment: Treadmills A feature or specification relative to treadmills that shouldn't be ignored is the drive train and belt/deck. Facilities with heavier usage should seek an AC-powered motor over DC-powered motors whenever feasible. With no brushes needed with AC motors, you'll save money in the long run by not needing replacement brushes like with DC motors. While facilities expecting lighter usage can feel comfortable with either the AC or DC motor. From a safety perspective, be sure that the drive train has Continuous Active Drive (CAD) so the belt speed is accurate during elevated grades to avoid accidental acceleration of the belt when a user walks at lower speed and high inclines. Finally, make sure the belt/deck of the treadmill is uniform over the entire walking surface to prevent any "sweet spots" to ensure a continuous soft effect regardless where a user would walk on the belt (front, middle or back). Health care providers can leverage as little as 400 square feet of space into a simple, yet powerful profit center. Although 400 square feet can work, 800 to 2,000 square feet is more ideal for on-site start-ups. On the other end of the spectrum, full-service Medical Fitness Centers (MFC) are averaging around 40,000 to 60,000 square feet, combining ambulatory therapies, medicine and fitness all under one roof.

What to Spend A general budgeting rule of thumb (without accounting for local demographics and cost of living) for expensing this equipment would be $4,000 to $6,000 per 100 square feet of space, and $90 to $110 per 100 square feet above any initial 10,000 square feet. Depending on your market, availability of space and business plan of attack, average necessary capital to purchase exercise equipment for the on-site start-up could range as low as $16,000 to as high as $120,000. These start-up ranges also fit with many of the leasing options available which allow for immediate start-up. I recommend using only 80% of the formulated capital of your initial start-up and leaving the remaining 20% for capital fitness equipment purchases as a reserve for between months six to 12 of operation. This will secure value within your existing members through re-investment and the ability to adjust to the membership needs and requests. In closing, remember as you prepare to provide a fitness and wellness component for added business, it is, and will be, an extension of your core practice. Your target audience looks to you for the best in health care and will expect that same excellence from you when it comes to delivering fitness and wellness services.